Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul

A 56 year old, female patient with a body surface area (BSA) of 1.9 m2, who had undergone aortic valve replacement (size no 19, mechanical valve) 12 years ago, presented with mechanical valve dysfunction due to pannus formation. The echocardiography revealed increased interventricular septum thickness (1.8 cm), small aortic root [2cm (<1 cm/m2)] and gradient accross the mechanical valve (mean: 55 mmHg, maximal: 110 mmHg). In her emergent reoperation, based on the BSA of the patient, the size of the previous mechanical valve and echocardiographical findings, the Konno aortoventriculoplasty technique was used for aortic root enlargement, which enabled a mechanical valve replacement of size no 23. After an uneventful recovery period of eight days she was discharged from the hospital. After a three-months follow-up she was class I. The control echocardiography revealed a septum thickness of 1.7 mm and 10 mmHg gradient accross the mechanical valve. Konno aortoventriculoplasty may safely be performed in adult patients in repeat aortic valve replacement of a valve of appropriate size for the patients' age, BSA and life style.